UNICEF advocates for the fulfillment of the Millennium Development Goals with equity

By: Anthony Lake, UNICEF Executive Director

For decades we have accepted the fact that a baby born in an affluent community/country has a far greater chance of leading a longer and healthier life than one born in poverty. In spite of our efforts to build a brighter future for all children, this inequity seemed to many of us in the international aid community to be a harsh reality that is all but impossible to reverse.

Consider, for example, the odds stacked against children born in the poorest countries. For every ten children born in sub-Saharan Africa, one or two will die from something as preventable as a mosquito bite. About four will suffer the irreversible stunted growth that results from malnutrition. Three will never spend a single day in school. And instead of living an average of 80 years – as their peers in industrialized countries do – their life expectancy is cut down to about fifty.

A decade ago, the world set eight Millennium Development Goals (MDGs) aimed at improving these terrible numbers by 2015. We’ve made progress. But in many areas, a close look at the numbers shows us that with progress have come widening disparities between the most and least deprived – for child mortality, sometimes by more than 10%.

This week world leaders convene at the UN to review the MDGs. The question is: can we reach our goals faster?

We can—not just by spending more money but by spending it to greater effect.

That’s the lesson of “Narrowing the Gaps to Meet the Goals,” the new study UNICEF released last week.

Carefully researched and peer-reviewed, “Narrowing the Gaps” offers not just new analysis but a new approach. For it disputes the common belief that we save more lives in poor countries by focusing on those more reachable; that putting the very poor at first on the list is right in principle, but wrong in practice.

The outcome of UNICEF’s work shows that in this case, principle and practice go are very closely linked. An “equity” focus— approaches aimed at the most deprived— will save more children per dollar than the one we use now.

Why? Partly because we have learned much about health since 2000—for example the way sound nutrition in the first two years of life can avert the stunting that afflicts almost 200 million children in the developing world. Partly because new technology like cell phones allow us to communicate with the most isolated villages on the planet.

The combination means we can now more efficiently deliver low-tech ways to treat the poor. For the hundreds of thousands of women dying during pregnancy and in childbirth each year, often because they give birth without skilled help, we can train non-physicians to perform caesareans. For the 850,000 children a year dying from malaria we can provide mosquito nets that reduce their deaths by 20%.

An equity focus doesn’t mean abandoning the worthwhile projects underway, but building on them. And the UNICEF study’s modeling does show that if we build by focusing future efforts on the poorest areas we will achieve dramatic results.

By 2015, for example, every $1 million the poorest countries shift to the new approach would save about 60% more children each year.

Naturally, one study is not the last word on a complex issue. But the thoroughness of UNICEF’s data makes it much more than a first step.

That’s particularly true because UNICEF researchers guarded against the impulse to satisfy our own biases by working with distinguished outside consultants. At a recent day-long review of the study, they enthusiastically supported our work.

At UNICEF we are all a little astonished. Being right in principle turns out to be right in practice. While the developing world desperately needs more money for health care, this approach offers more health care for the money we have. The policy implications that follow from what we found offer sustainable new opportunity to save and help so many more children.

We can’t be content only to see that opportunity. We must seize it.

At UNICEF we have already begun to move where the facts lead us. We see results in simple things: the drop of polio vaccine squeezed onto a child’s tongue in Tajikistan, where we helped head off an epidemic; a Sudanese mother filling a container with clean water from the newly drilled borehole in her village; a young girl in a classroom in Afghanistan where only 40% of girls ever attend elementary schools. [REPLACE THE BOLDED TEXT WITH REGION-SPECIFIC EXAMPLES OF UNICEF PROGRAMMING SUCCESSES.]

In the final five years of a mission created with such hope, and carried on with such dedication, we urge our partners gathering for the UN Summit: help the most children by focusing on those who need help the most.

And we urge readers to recognize that the fate of these children is linked to the fate of our own. In order to create a better world for all of our children – regardless of where they were born – we must even the odds. This new study offers a bold vision of a world in which poverty need no longer be a life sentence for any child.

About UNICEF UNICEF is on the ground in over 155 countries and territories to help children survive and thrive, from early childhood through adolescence. The world’s largest provider of vaccines for developing countries, UNICEF supports child health and nutrition, good water and sanitation, quality basic education for all boys and girls, and the protection of children from violence, exploitation, and AIDS. UNICEF is funded entirely by the voluntary contributions of individuals, businesses, foundations and governments.